“One man’s food may be another man’s poison”—Understanding food allergy

Article: “One man’s food may be another man’s poison”—Understanding food allergy

Food is essential to our life as it provides energy and nutrients.  All of us eat to survive, and most of us enjoy eating.  However, some people indeed cannot tolerate some kinds of food and may develop adverse reaction afterwards.

Differences between Food Allergy and Food Intolerance

Are food allergy and food intolerance interchangeable?  Both are food reactions but they are different.  Food allergy can be serious and life-threatening; even a tiny bit of allergic food can cause immediate (symptoms may occur within minutes to 2 hours) and severe reactions such as nausea, vomiting, diarrhea, nasal congestion, stomach cramps, shortness of breath, angioedema of the lips, face, tongue and throat, and etc.  Its abnormal response to a food protein involves the immune system and there is no cure for food allergy, a complete and strict avoidance of the food allergen is the only prevention from the adverse reactions.

The prevalence of food allergy in children has shown an increase of 18% between 1997 and 2007.  Eight foods causing 90% of allergic reactions in the United States are as follows:

Milk	Eggs
Wheat	Soy
Peanuts	Tree nuts
Fish	Shellfish

On the other hand, food intolerance reactions are of slower onset (symptoms occur hours to days) and do not involve the immune system.  Food intolerances are much common than food allergies.  Lactose intolerance, coeliac disease and wheat intolerance are types of food intolerance.

Diagnosis of food allergy

It is necessary to visit your doctor if you are suspected from food allergy, a skin prick test, specific IgE and basophil histamine release are the methods for allergy testing.  Once the allergenic foods are suspected, a restricted and tailor made diet should result in the disappearance of symptoms or at least a significant reduction.  Such diagnostic diet may be prescribed by the dietitian and should be supervised by the doctor.

To food allergic people: How to avoid?

Basic tips for eat out/take-away meals

1.     Read the menu thoroughly

2.     Ask the waiter/waitress if in doubt

3.     Inform the chef in advance booking

4.     Watch out for hidden ingredients

-Peanut oil used in cooking

-Peanuts in satay sauce, chocolate, ice cream or candy bars

        -Nuts in cake/dessert

5.  Always bring the emergency treatment kit (Injectable epinephrine)

Food labeling

Food label is mandatory in UK or the rest of the European Unit and the following food ingredients must be clearly illustrated on the food package:

Peanuts	Tree nuts	Eggs
Milk	Fish	Crustaceans (lobsters, crabs and prawns)
Sesame seeds	Soya	Cereals containing gluten (wheat, rye, barley and oats)

Nutritional management

Nutritional management is important in food allergy.  Prolonged food avoidance may lead to specific nutrient deficiency and consequently, a disorder may arise.  It is necessary to talk to a dietitian regarding to the diet plan and the management should include:

1.     Total avoidance of food allergens

2.     Education on food allergy

3.     Provide alternative nutrient sources

4.     Sample meal plan

Food challenge test may be given over a few weeks and after following the food challenge test, the suspected allergenic food will be reintroduced to the diet.  Recording any allergy symptoms that occur when the food is reintroduced helps to confirm the diagnosis.  However, if a severe reaction to the food has had resulted, food challenge test cannot be used.

Feel and live better

Some food allergies can be outgrown and if they don’t, a balanced diet is important in order to keep ourselves healthy and remember there is always a substitution.

 

Written by: CHEUNG Michelle Chi-Kwun, R.D.